Senior Manager / Associate Director, Market Access & Reimbursement

Cleveland Diagnostics (CDx) is a fast-growing biotechnology company focused on developing next-generation diagnostic platforms for complex diseases. The Senior Manager / Associate Director of Market Access and Reimbursement will refine and execute the commercial coverage strategy for CDx’s diagnostics portfolio, ensuring patient access through effective coding and reimbursement strategies.

Responsibilities:

• Refine coverage, coding, and payment strategies for existing and new products for both public and private payors
• Secure unique CPT, PLA, or ICD-10 diagnostic codes as needed
• Create and refine compelling, evidence-based payor value dossiers and other marketing materials for public and private payers
• Align clinical trial endpoints to address payer evidence requirements, including cost effectiveness modeling and clinical utility studies
• Work with CDx Billing to analyze market and payor trends, broad policy changes, and other reimbursement dynamics (e.g., reimbursement landscape for competitive products)
• Build relationships with medical directors at regional and national commercial health plans, as well as at Medicare Administrative Contractors (MACs)
• Present clinical and economic data to secure positive coverage policies
• Partner with health economics firms to build cost-effectiveness models
• Work with CDx Marketing to mobilize patient advocacy groups and clinicians to support coverage
• Advise CDx R&D and Clinical teams on clinical utility study design
• Along with CDx Billing and our reimbursement consultants, monitor changes among
• Work with CDx Billing to train internal sales teams on billing and prior authorization processes
• Coordinate with CDx Sales leadership to inform team as to new coverage policies and contracting developments that are locally important to CDx account executives and their key accounts
• Ensure all market access activities meet healthcare compliance standards

Requirements:

• 10+ years healthcare industry experience
• 7+ years in reimbursement and market access, with a strong preference for diagnostics experience in the oncology field
• Bachelor's degree or advanced degree in related field
• Prior success in market access across both LDT or IVD products
• Deep understanding of HEOR, managed care, and health policies
• Proven ability to thrive in ambiguous environments
• Strong communication skills
• Demonstrated ability to work cross-functionally
• Internal relationship-building
• Advanced degree such as MBA
• Experience with advanced diagnostics, point-of-care, or oncology tools